TY - JOUR
T1 - Individualized nutritional intervention during and after hospitalization
T2 - The nutrition intervention study clinical trial
AU - Feldblum, Ilana
AU - German, Larisa
AU - Castel, Hana
AU - Harman-Boehm, Ilana
AU - Shahar, Danit R.
PY - 2011/1
Y1 - 2011/1
N2 - OBJECTIVES: To test the hypothesis that individualized nutritional treatment during and after discharge from acute hospitalization will reduce mortality and improve nutritional outcomes. DESIGN: Randomized, controlled trial. SETTING: Internal medicine departments. PARTICIPANTS: Two hundred fifty-nine hospitalized adults aged 65 and older at nutritional risk were recruited and randomized according to hospitalization ward into one intervention and two control groups during hospitalization. INTERVENTION: Group 1 (intervention group) received individualized nutritional treatment from a dietitian in the hospital and three home visits after discharge. Group 2 received one meeting with a dietitian in the hospital. Group 3 received standard care. Groups 2 and 3 were combined into a single group that served as the control group in the analysis. MEASUREMENTS: Mortality, health status, nutritional outcomes, blood tests, cognition, emotional, and functional parameters were assessed at baseline and after 6 months. All participants were contacted monthly. RESULTS: The overall dropout rate was 25.8%. After 6 months, rise in Mini Nutritional Assessment score, adjusted for education and hospitalization ward, was significantly higher in the intervention group than in the control groups (3.01 ± 2.65 vs 1.81 ± 2.97, P=.004) mainly on the subjective assessment part (0.34 ± 0.86 vs. -0.04 ± 0.87, P=.004). The only laboratory parameter for which a difference was observed between the groups was albumin; 9.7% of the intervention group had serum albumin levels of less than 3.5 g/dL, versus 22.9% of the control group (P=.03). Mortality was significantly lower in the intervention group (3.8%) than in the control group (11.6%, P=.046). CONCLUSION: Lower mortality and moderate improvement in nutritional status were found in patients receiving individualized nutritional treatment during and after acute hospitalization.
AB - OBJECTIVES: To test the hypothesis that individualized nutritional treatment during and after discharge from acute hospitalization will reduce mortality and improve nutritional outcomes. DESIGN: Randomized, controlled trial. SETTING: Internal medicine departments. PARTICIPANTS: Two hundred fifty-nine hospitalized adults aged 65 and older at nutritional risk were recruited and randomized according to hospitalization ward into one intervention and two control groups during hospitalization. INTERVENTION: Group 1 (intervention group) received individualized nutritional treatment from a dietitian in the hospital and three home visits after discharge. Group 2 received one meeting with a dietitian in the hospital. Group 3 received standard care. Groups 2 and 3 were combined into a single group that served as the control group in the analysis. MEASUREMENTS: Mortality, health status, nutritional outcomes, blood tests, cognition, emotional, and functional parameters were assessed at baseline and after 6 months. All participants were contacted monthly. RESULTS: The overall dropout rate was 25.8%. After 6 months, rise in Mini Nutritional Assessment score, adjusted for education and hospitalization ward, was significantly higher in the intervention group than in the control groups (3.01 ± 2.65 vs 1.81 ± 2.97, P=.004) mainly on the subjective assessment part (0.34 ± 0.86 vs. -0.04 ± 0.87, P=.004). The only laboratory parameter for which a difference was observed between the groups was albumin; 9.7% of the intervention group had serum albumin levels of less than 3.5 g/dL, versus 22.9% of the control group (P=.03). Mortality was significantly lower in the intervention group (3.8%) than in the control group (11.6%, P=.046). CONCLUSION: Lower mortality and moderate improvement in nutritional status were found in patients receiving individualized nutritional treatment during and after acute hospitalization.
KW - acutely hospitalized
KW - elderly
KW - nutrition
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=78651392409&partnerID=8YFLogxK
U2 - 10.1111/j.1532-5415.2010.03174.x
DO - 10.1111/j.1532-5415.2010.03174.x
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
AN - SCOPUS:78651392409
SN - 0002-8614
VL - 59
SP - 10
EP - 17
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 1
ER -